Why the study?
Epithelioid angiosarcoma is a rare variant mimicking carcinoma that is easily misdiagnosed as bone metastasis and has an aggressive clinical course.
Multicentric epithelioid angiosarcoma of the bone can mimic metastatic carcinoma and requires immunohistological staining for vascular markers for accurate diagnosis.
Multicentric epithelioid angiosarcoma may mimic carcinoma bone metastases; single case leaves open need for refined diagnostic criteria.
Epithelioid angiosarcoma is a rare variant of angiosarcoma characterized by an epithelioid morphology that mimics carcinoma. Therefore, multicentric epithelioid angiosarcoma is easily misdiagnosed as bone metastasis from carcinoma and has an aggressive clinical course. Here, we present a rare case of a 61-year-old male with multicentric epithelioid angiosarcoma of the bone. Plain radiography, CT, and MRI revealed multiple osteolytic lesions in both femurs; some lesions showed soft tissue extension with cortical bone destruction. Interestingly, PET-CT revealed that the lesions were only distributed along the bones of the lower extremities, including the pelvic bones, femurs, and tibiae. Despite histological analysis initially suggesting metastatic carcinoma, after additional immunohistological staining, including that for vascular markers (CD31 and ERG), the final diagnosis was epithelioid angiosarcoma. A better understanding of the clinicoradiological features of this disease may help eliminate diagnostic confusion and provide better management.
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Choi et al. (2023) studied this question.
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